Exit Interview Format

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EXIT INTERVIEW FORM

NAME OF THE EMPLOYEE :

DESIGNATION AND LOCATION :

DATE OF JOINING :

DATE OF RESIGNATION : _____________________________________

DATE OF RELIEVING : _____________________________________

1. Brief History in ……..(Org. name)

♦ Department Served : _____________________________________

♦ Training sponsored : _____________________________________

♦ Transfer etc. : _____________________________________

♦ Any other : _____________________________________

_____________________________________________________________________

2. What are your major contributions to the Department/Organisation?

_____________________________________________________________________

_____________________________________________________________________

3. Were you happy with your job and the workload?

_____________________________________________________________________

_____________________________________________________________________

4. Did you get along with your boss and receive the guidance?

_____________________________________________________________________

5. Were your skills optimally utilised and got recognition?

_____________________________________________________________________

6. What were the major reasons of your joining ……… (Org. Name)?

_____________________________________________________________________

7. Would you consider returning to this company in the future?


8. Have you found any difference in your expectations and the reality which existed
concerning your job (please specify)

_____________________________________________________________________

_____________________________________________________________________

9. What are your reasons for separation?

_____________________________________________________________________

_____________________________________________________________________
10. (A) What in your opinion are the strengths of the ………(Org. Name).?

_____________________________________________________________________

(B) Threats the Organisation or unit is facing :

_____________________________________________________________________

11 Any suggestion you would like to provide related to the Department / Unit which can
help in better improvement.

_____________________________________________________________________

12 Any other suggestions related to Corporate Policies / Rules etc.:

_____________________________________________________________________

_____________________________________________________________________

Exit Interview by: Date:

REMARKS BY INTERVIEWER AND RECOMMENDED ACTION PLAN

___________________________________________________________________________

___________________________________________________________________________

COMMENTS OF HRD AND ACTION PLAN

___________________________________________________________________________

COMMENTS OF BUSINESS HEAD

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